Individual provider Active NPI

Robert D Rosenberg, MD

  • Psychiatry Physician
  • Gardena, CA
National Provider Identifier
1437110400
Registry record updated Mar 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A43166 Issued in CA
Practice address
1225 W 190TH St Ste 280
Gardena, CA 90248-4305
Phone
(310) 515-8113
Fax
(310) 538-2102
NPI assigned
Mar 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A43166 CA Primary

Addresses

Primary practice location

1225 W 190TH St Ste 280
Gardena, CA 90248-4305

Mailing address

3537 Mesquite Dr
Calabasas, CA 91302-2073
Phone (818) 523-2540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040813000409 CA Practitioner - Psychiatry 0042283533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ehab Yacoub MD IncGroup PAC ID 5092099523, 179 clinicians

Practice addresses (Care Compare)

1225 W 190TH St
Suite 280
Gardena, CA 90248-4305
Phone (877) 515-8113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
43166CAMDGeneral Practice Dentistry
A43166CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ehab Yacoub MD Inc. CurrentSince Apr 10, 2023 Accepting new patients

Locations

1225 W 190th St
Ste 280
Gardena, CA 90248
Phone (310) 515-8113

17075 Devonshire St
Ste 204
Northridge, CA 91325
Phone (818) 368-8929

3200 E Guasti Rd
Ste 100
Ontario, CA 91761
Phone (877) 414-7739

11801 Pierce St
Ste 200
Riverside, CA 92505
Phone (323) 547-2662

473 S Carnegie Dr
Ste 200
Sn Bernrdno, CA 92408
Phone (562) 803-4500

14541 Delano St
Van Nuys, CA 91411
Phone (310) 515-8113

6320 Canoga Ave
Fl 15
Woodland Hls, CA 91367
Phone (818) 588-4003

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679788800000",
    "number": "1437110400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3537 MESQUITE DR",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913022073",
            "telephone_number": "818-523-2540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 W 190TH ST STE 280",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902484305",
            "telephone_number": "310-515-8113",
            "fax_number": "310-538-2102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "ROBERT",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2023-03-26",
        "certification_date": "2023-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A43166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

Verify at the official NPI Registry.